Last week, the United Nations concluded one of the last negotiations on the road to adopting the Sustainable Development Goals in September. We’ve entered the home stretch of a process that has taken more than two years, bringing governments, civil society organizations, and communities together to define the development goals and targets that UN member states will be expected to aim for over the next 15 years.

The result? Seventeen goals and 169 targets, covering everything from global health to urbanization to marine life. While these goals and targets are more or less set, the question of implementation remains open. How are governments going to achieve so many targets? One thing that is clear is that there will need to be more holistic development efforts that cross traditional sectoral boundaries, like health or the environment.

As we move from global goal setting to national and local implementation, there is much we can learn from the past. Over the last decade, Pathfinder International, the Sierra Club, PAI, and others have collaborated around a global development approach known as population, health and environment (PHE), an integrated, community-based approach that works to expand access to reproductive and other health care services, improve livelihoods, manage resources, and protect the environment. PHE is a strong reference point for thinking about how to achieve the SDGs.

The PHE approach improves access to sexual and reproductive health services in hard-to-reach and underserved areas while empowering communities with the knowledge and tools needed to manage their natural resources sustainably. The premise is that these two goals are linked in many remote rural areas that are far from government services and reliant on the environment for their livelihoods. Unmet demand for family planning is often high and giving couples the opportunity to choose the timing and number of children they want allows them greater control over their family’s health and wellbeing, and the health of the environment.

PHE programs conserve critical ecosystems and resources, contribute to better health outcomes, and expand livelihood options – all key components of the SDGs. This approach has also been shown to lower opportunity costs to accessing services, improve understanding of linkages between human and ecosystems health, and promote broad community buy-in.

The general integrated approach of PHE is a useful model to learn from for future efforts, but this specific combination of interventions is also addressing many of the SDGs already:

SDG 1: End poverty in all its forms everywhere

PHE programs focus on the needs of impoverished and isolated communities that rely on dwindling natural resources. For instance, higher temperatures and unsustainable fishing practices are severely impacting the productivity of Lake Tanganyika, which provides 40 percent of the protein to lake shore villages in the Democratic Republic of Congo, Burundi, Tanzania, and Zambia. An ongoing PHE project called Tuungane is addressing the needs of Tanzanian villages holistically by providing access to health services, alternative livelihood training, and improving agricultural practices in order to alleviate some of the pressure on the lake ecosystem.

SDG 2: End hunger, achieve food security and improved nutrition, and promote sustainable agriculture

PHE interventions in settings where dependency on natural resources is high have improved food security. For example, coastal communities in the Philippines that participated in a PHE program were able to diversify their incomes and rely less on fishing as their primary livelihood as compared to communities that only participated in a coastal resource management intervention. A broader base of income generating activities increased food security and the reduced level of fishing has allowed local fish stocks to recover.

SDG 3: Ensure healthy lives and promote wellbeing for all at all ages

Women who are able to plan their family size are more resilient to climate disruption, more likely to participate in local conservation efforts, and better able to manage resources for their families. PHE programs include, at minimum, the advancement of family planning and reproductive health services as one of their key objectives.

SDG 5: Achieve gender equality and empower all women and girls

In Ethiopia, husbands who participated in a PHE project were four times more likely to support the use of family planning than husbands exposed to a reproductive health-only program. Ensuring universal access to sexual and reproductive health and reproductive rights is fundamental to achieving gender equality and PHE has proven to be an effective way to spread this message to new audiences.

SDG 6: Ensure availability and sustainable management of water and sanitation for all

The rural poor are more likely to suffer from poor drinking water and sanitation than their urban counterparts. Newer generations of PHE projects have included water, sanitation, and hygiene (WASH) interventions and most have reported a change in household hygiene behaviors and therefore improved health outcomes as a result.

SDG 10: Reduce inequality within and among countries

PHE is effective in serving the multi-dimensional needs of remote, highly marginalized, traditional populations where single-sector approaches have not succeeded. Using PHE programs to reach underserved populations leads to improved access to health care, uptake of services, and increased engagement in natural resources management. Modern PHE approaches are now showing early successes in using these experiences to institutionalize change at higher levels of governance too which may support long-term reductions in inequality.

The recent Rockefeller Foundation-Lancet Commission on Planetary Health is among a growing number of warnings that human activity is “jeopardizing Earth’s natural systems and the health of future generations.”

Achieving the SDGs will demand interdisciplinary, practical, locally relevant, and long-lasting solutions. As we move from a conversation about goals to one about implementation, achieving the benefits we want depends on a number of factors that PHE has grappled with already:

• Community engagement in all aspects of program design, implementation, and assessment, especially with women, who are often marginalized.
• Coordination between environmental, health, and community development groups, and effective cross-sectoral project management.
• Integrated funding that supports a holistic vision of success.
• Inclusion of sexual and reproductive health and rights as a key component of any integrated health and development intervention.
• Equitable distribution of life-saving commodities for women and children’s health to isolated, often ecologically fragile, underserved areas of the world.
• Research on integration and its impact on development results.

We have accomplished a tremendous feat in agreeing to an ambitious set of global goals, but now is the time to roll up our sleeves. These are just a few of the ways the SDGs overlap with PHE. We need to step out of sectoral comfort zones and learn from the experience of PHE in integrated design and implementation. If done right, we can reap great benefits for human, ecosystem, and planetary wellbeing.